Phloroglucinol in Irritable Bowel Syndrome

Objective: To determine the efficacy and tolerability of phloroglucinol, an antispasmodic agent in the treatment of Irritable Bowel Syndrome (IBS). Methods: It was an open label (quasi interventional) study. One hundred patients coming to the gastroenterology clinics of Aga Khan University Hospital with IBS as defined by the Rome II criteria were enrolled between February 2004 and September 2004 to participate in the trial and were treated as outpatients. Phloroglucinol (Himont) 50mg orally three times daily was given for two months. Symptoms were assessed before and during treatment using a questionnaire. Results: One hundred patients were enrolled in the study. Of them 61% (61/100) were males and 39% (39/100) were females. Their mean age was 41±14 years. Sixty-eight patients completed the study and 28 dropped out. On Phloroglucinol treatment there was an overall statistically significant improvement in abdominal pain (p\u3c0.001), frequency of stools per day (p\u3c0.001), urgency (p\u3c0.001), passage of mucus per rectum (p\u3c0.001),sense of incomplete defecation (p=0.001) and bloating (p=0.001). However, no response was seen in the feature of straining in both genders (p=0.676). The difference in response to treatment according to gender separately showed statistically significant improvement in the sense of incomplete defecation in females alone(p=0.003). Conclusion: Phloroglucinol in a dose of 50mg three times daily is effective and well tolerated by the IBS patients. It relieves most of the symptoms of IBS (JPMA 56:5;2006

An appraisal of the World Bank role in the development of education in Pakistan with a focus on higher education

The World Bank, like many other non-governmental organisations, is engaged in the developing countries with an objective to bring social and economic development. In Pakistan, the World Bank (WB) appeared on the horizon soon after the independence of the country in 1947. Hitherto, for the development of different sectors including education, WB has lent billions of dollars and launched hundreds of projects in Pakistan. This research has been conducted to have an in-depth look into the role played by the WB in the development and progress of education sector from 1964 to 2009. In this study, a special focus has been given to the higher education. The author has evaluated the volume of the WB lending, nature of the projects, the shares for the sub-sectors of education, changes and trends in the investment in education sector. An attempt also has been made to evaluate the possible impact of the WB loans and projects on the education sector in general and higher education sub-sector in particular. The WB investments in education sector have also been compared with other sectors to have a broader picture. For new readers and those who are interested in education statistics a detailed county profile, on the basis of most recent data, has also been presented and discussed in this article. This practical information on the country profile can be very helpful in establishing a better understanding of the present scenario, condition and status of education in Pakistan. Moreover it will help to understand the need and significance of national and international organisations for education. Keywords: The World Bank, education, higher education, projects, lending, investment, development, impac

Diagnostic utility of anti-citrullinated protein antibody and its comparison with rheumatoid factor in rheumatoid arthritis

Objective: To assess the diagnostic utility of anti-citrullinated protein antibody (anti-CCP) in rheumatoid arthritis (RA) and compare it with rheumatoid factor (RF). Study Design: Analytical study. Place and Duration of Study: Section of Chemical Pathology, Department of Pathology and Microbiology and Medicine, the Aga Khan University, Karachi, from January to May 2010. Methodology: A review of medical records of patients presenting to the clinics with complaints of muscular or joint pains and who were tested for their serum anti-CCP was done. Inclusion criteria were presence of clinical synovitis in at least one joint and an absence of alternative diagnosis. Patients with arthralgia alone or with missing acute phase reactants information were excluded. Scoring and classification of RA was done using the 2010 RA Classification Criteria by the American College of Rheumatology (ACR). Results: Out of the 98 charts reviewed, ACR criteria showed 54 cases with RA. The mean age of the group was 46 ± 15 years, 82.7% being females. High titers of anti-CCP corresponded with the ACR scores. The sensitivity and specificity of anti-CCP and RF reactivity for the diagnosis of RA were 54.7% and 95.5% versus 59.3% and 88.4% respectively. Conclusion: Anti-CCP is useful for the diagnosis of RA due to its higher specificity as compared to RF and can predict disease severity

Expansion of quality assurance mechanism in south Asian higher education system: an empirical analysis

Higher education institutions in south Asia are faced with two fold pressure; need to expand and demand to enhance the quality. In this region mechanism of quality assurance is at very nascent stage and faced with problems of resources limitations: economic resources are insufficient and human resources are under-developed. But the expansion and implementation of QA mechanism is helping to improve the quality of higher education and better utilization of resources. Assistance of international organizations, which are working for quality assurance mechanism, is important to enhance human capacity QA mechanisms’ credibility. This study is designed to map the state of higher education and quality assurance, to investigate into the role of international organization (INQAAHE) in the expansion of QA and to probe the questions: What are south Asian countries doing for quality enhancement and assurance? How is it expanding? What are the national needs? Keywords: Higher Education, Quality Assurance, INQAAHE, South Asi

The Effect of Macroeconomic Uncertainty on Consumption Expenditure in Case of Pakistan

Government expenditure on consumption is the core issue in the macroeconomic theory. The determination of national economic growth and the improvement of economic production also play an important role in economic and technological progress. However, a high degree of macroeconomic uncertainty directly inhibits economic growth. This study empirically estimates the macroeconomic determinants of government spending in Pakistani economy. In this study, ARCH, GRACH model was used to calculate the volatility of different macroeconomic variables. Taking the period from 1975 to 2014 in Pakistan as an example, the ARDL model was used to examine the relationship between the volatility of macroeconomic variables and government spending. The research shows that the macroeconomic uncertainty caused by the fluctuation of macroeconomic variables has a significant impact on the government's consumption expenditure. Empirical results from the study show that Pakistan experienced more volatility in the macroeconomic variables, leading to more volatile government spending and private investment

Relationship between Volatility of Economics Variables and Economics Growth

Economic growth of an economy is defined as the steady state path through which the productivity of an economy is improved and increases the levels of national output and income. The government consumption expenditures and investment play a key role in the process of investigating the macroeconomic performance of an economy and determinants of economic growth. The countries which grow quickly, invest a substantial fraction of their GDP for consumption expenditures as well for the sources which encourage private investment. The objective of this study to calculate the volatility in economics growth in Pakistan. The annual time series data are used from 1975 to 2014 from WDI, Economics survey of Pakistan and Hand Book of Statistics. GARCH model has been used to measure volatility of all variables. The empirical results of the study confirmed that the volatility of the different variables (volatility of inflation, volatility of interest rate, volatility of political instability, volatility of GDP, and volatility of foreign direct investment) significant affect the government consumption expenditures and private investment in the economy of Pakistan. The study analyzed data by using the autoregressive distributive lag model which is mainly used in time series data Econometrics to estimate the non-stationary models with mix order of integration. The estimated results of the study evaluated that volatility of the inflation lead to uncertainty which is also suggested by the Able (1980) and negatively affect the economy consumption expenditures as well as private investment in the economy of Pakistan. Because uncertainty directly affects the cost of capital as well as reduce private investor confidence

Molecular confirmation of the causes of inherited visual impairment in Northern Pakistan

Families with inherited visual impairment were identified and examined from January 2000 to December 2005 and given a clinical diagnosis. Known genes and loci were screened for mutations or linkage at Institute of Ophthalmology and Neurosciences, University of Leeds, in order to provide molecular confirmation. Inherited retinal disease was the most common cause of inherited visual impairment in 38 of 57 families (66.6%) with Leber\u27s congenital amaurosis, rod-cone dystrophy and cone-rod dystrophy being the most common diagnoses in 22, 8 and 3 families respectively. Anterior segment dysgenesis was diagnosed in 8 families (14%). Mutations in known genes or linkage to known loci were identified in 23 of 57 families (40%). All families had molecular confirmation of autosomal recessive inheritance or a pedigree consistent with this mode of inheritance, with evidence of first-cousin marriage. Knowledge of carrier status and genetic counseling may allow families to make an informed decision regarding marriage, and thus begin to plan a way of reducing the incidence of inherited visual impairment

English Background as the Predictors for Students’ Speaking Skills in Pakistan

This paper is based on the English background of the students as the predictors for students English speaking skills at the secondary level at province of Sindh, Pakistan. A questionnaire was designed for students of grade-11, which was used to collect data from 60 male students of the public institutes in district Hyderabad, Pakistan. There were three independent variables used in this study: (X1) either students attended English language institute, (X2) number of years students were educated in English medium schools, and (X3) last class’s English score. The dependent variable was English speaking score (Y). Students’ speaking skills were assessed by a standardized rubric designed by language experts. There were four research questions formulated. Data was analyzed using linear and multiple regression, and t-test in SAS 9.2 (Statistical Analysis System). With ?=0.05, the result indicates that there is a significant relationship between student last class’s English score (N=60, M=50.45, SD=9.00) and their speaking scores (N=60, M=11.77, SD=3.21), r = 0.73, p<0.001. The number of years educated in English medium school (b = 0.22, t =2.05) and last class’s English score (b = 0.26, t = 8.26, p <.0001) were found significant predictors at R2 =0.57, F(2,57) =37.20, p<0.001. No statistical significance was indicated in students speaking score between those who attended English language institute (N=48, M= 12.04, SD= 3.43) and those who did not attend an English language institute (N=12, M= 10.67, SD= 1.83), t(58)= –1.34, p = 0.19. Interaction with students showed that most of the students do not speak English with fellow students because of shyness and lack of confidence. Keywords: English speaking, language, speaking skills, secondary schoo

English Background as the Predictors for Students’ Speaking Skills in Pakistan

This paper is based on the English background of the students as the predictors for students English speaking skills at the secondary level at province of Sindh, Pakistan. A questionnaire was designed for students of grade-11, which was used to collect data from 60 male students of the public institutes in district Hyderabad, Pakistan. There were three independent variables used in this study: (X1) either students attended English language institute, (X2) number of years students were educated in English medium schools, and (X3) last class’s English score. The dependent variable was English speaking score (Y). Students’ speaking skills were assessed by a standardized rubric designed by language experts. There were four research questions formulated. Data was analyzed using linear and multiple regression, and t-test in SAS 9.2 (Statistical Analysis System). With ?=0.05, the result indicates that there is a significant relationship between student last class’s English score (N=60, M=50.45, SD=9.00) and their speaking scores (N=60, M=11.77, SD=3.21), r = 0.73, p<0.001. The number of years educated in English medium school (b = 0.22, t =2.05) and last class’s English score (b = 0.26, t = 8.26, p <.0001) were found significant predictors at R2 =0.57, F(2,57) =37.20, p<0.001. No statistical significance was indicated in students speaking score between those who attended English language institute (N=48, M= 12.04, SD= 3.43) and those who did not attend an English language institute (N=12, M= 10.67, SD= 1.83), t(58)= –1.34, p = 0.19. Interaction with students showed that most of the students do not speak English with fellow students because of shyness and lack of confidence. Keywords: English speaking, language, speaking skills, secondary school